|
MS-DRG 42.00: CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES
|
Facility
|
IP
|
$1,143,301.24
|
|
|
Service Code
|
MSDRG 018
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$1,143,301.24 |
| Rate for Payer: Aetna of CA HMO/PPO |
$1,143,301.24
|
| Rate for Payer: EPIC Health Plan Commercial |
$560,369.81
|
| Rate for Payer: EPIC Health Plan Senior |
$415,088.75
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$415,088.75
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$415,088.75
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$556,218.93
|
| Rate for Payer: Multiplan WC |
$704,529.93
|
| Rate for Payer: Prime Health Services WC |
$697,340.85
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC
|
Facility
|
IP
|
$59,968.08
|
|
|
Service Code
|
MSDRG 415
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$59,968.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,968.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,947.19
|
| Rate for Payer: EPIC Health Plan Senior |
$39,220.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,220.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,220.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,554.99
|
| Rate for Payer: Multiplan WC |
$36,953.78
|
| Rate for Payer: Prime Health Services WC |
$36,576.70
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC
|
Facility
|
IP
|
$106,221.20
|
|
|
Service Code
|
MSDRG 414
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$106,221.20 |
| Rate for Payer: Aetna of CA HMO/PPO |
$106,221.20
|
| Rate for Payer: EPIC Health Plan Commercial |
$74,611.71
|
| Rate for Payer: EPIC Health Plan Senior |
$55,267.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$55,267.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$55,267.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$74,059.03
|
| Rate for Payer: Multiplan WC |
$65,456.08
|
| Rate for Payer: Prime Health Services WC |
$64,788.16
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$44,315.15
|
|
|
Service Code
|
MSDRG 416
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$44,315.15 |
| Rate for Payer: Aetna of CA HMO/PPO |
$41,538.98
|
| Rate for Payer: EPIC Health Plan Commercial |
$44,315.15
|
| Rate for Payer: EPIC Health Plan Senior |
$32,826.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$32,826.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$32,826.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$43,986.89
|
| Rate for Payer: Multiplan WC |
$25,597.33
|
| Rate for Payer: Prime Health Services WC |
$25,336.13
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH CC
|
Facility
|
IP
|
$64,621.59
|
|
|
Service Code
|
MSDRG 412
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$64,621.59 |
| Rate for Payer: Aetna of CA HMO/PPO |
$64,621.59
|
| Rate for Payer: EPIC Health Plan Commercial |
$55,126.83
|
| Rate for Payer: EPIC Health Plan Senior |
$40,834.69
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$40,834.69
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$40,834.69
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$54,718.48
|
| Rate for Payer: Multiplan WC |
$39,821.39
|
| Rate for Payer: Prime Health Services WC |
$39,415.05
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITH MCC
|
Facility
|
IP
|
$82,956.70
|
|
|
Service Code
|
MSDRG 411
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$82,956.70 |
| Rate for Payer: Aetna of CA HMO/PPO |
$82,956.70
|
| Rate for Payer: EPIC Health Plan Commercial |
$63,714.82
|
| Rate for Payer: EPIC Health Plan Senior |
$47,196.16
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$47,196.16
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$47,196.16
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$63,242.85
|
| Rate for Payer: Multiplan WC |
$51,119.93
|
| Rate for Payer: Prime Health Services WC |
$50,598.29
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC
|
Facility
|
IP
|
$50,400.35
|
|
|
Service Code
|
MSDRG 413
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$50,400.35 |
| Rate for Payer: Aetna of CA HMO/PPO |
$50,400.35
|
| Rate for Payer: EPIC Health Plan Commercial |
$48,465.76
|
| Rate for Payer: EPIC Health Plan Senior |
$35,900.56
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$35,900.56
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$35,900.56
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$48,106.75
|
| Rate for Payer: Multiplan WC |
$31,057.92
|
| Rate for Payer: Prime Health Services WC |
$30,741.00
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC
|
Facility
|
IP
|
$37,057.69
|
|
|
Service Code
|
MSDRG 191
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$37,057.69 |
| Rate for Payer: Aetna of CA HMO/PPO |
$26,044.48
|
| Rate for Payer: EPIC Health Plan Commercial |
$37,057.69
|
| Rate for Payer: EPIC Health Plan Senior |
$27,450.14
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$27,450.14
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$27,450.14
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$36,783.19
|
| Rate for Payer: Multiplan WC |
$16,049.23
|
| Rate for Payer: Prime Health Services WC |
$15,885.47
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC
|
Facility
|
IP
|
$40,805.01
|
|
|
Service Code
|
MSDRG 190
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$40,805.01 |
| Rate for Payer: Aetna of CA HMO/PPO |
$34,044.87
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,805.01
|
| Rate for Payer: EPIC Health Plan Senior |
$30,225.93
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$30,225.93
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$30,225.93
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,502.75
|
| Rate for Payer: Multiplan WC |
$20,979.27
|
| Rate for Payer: Prime Health Services WC |
$20,765.20
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC
|
Facility
|
IP
|
$34,048.78
|
|
|
Service Code
|
MSDRG 192
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,048.78 |
| Rate for Payer: Aetna of CA HMO/PPO |
$19,620.52
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,048.78
|
| Rate for Payer: EPIC Health Plan Senior |
$25,221.32
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,221.32
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,221.32
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$33,796.57
|
| Rate for Payer: Multiplan WC |
$12,090.63
|
| Rate for Payer: Prime Health Services WC |
$11,967.26
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC
|
Facility
|
IP
|
$67,098.40
|
|
|
Service Code
|
MSDRG 286
|
| Min. Negotiated Rate |
$4,504.00 |
| Max. Negotiated Rate |
$67,098.40 |
| Rate for Payer: Aetna of CA HMO/PPO |
$67,098.40
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$56,286.95
|
| Rate for Payer: EPIC Health Plan Senior |
$41,694.04
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$41,694.04
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$41,694.04
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$55,870.01
|
| Rate for Payer: Multiplan WC |
$41,347.66
|
| Rate for Payer: Prime Health Services WC |
$40,925.75
|
| Rate for Payer: United Healthcare All Other Commercial |
$20,829.00
|
| Rate for Payer: United Healthcare All Other HMO |
$20,011.00
|
| Rate for Payer: United Healthcare HMO Rider |
$15,202.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,927.00
|
|
|
MS-DRG 42.00: CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC
|
Facility
|
IP
|
$40,332.14
|
|
|
Service Code
|
MSDRG 287
|
| Min. Negotiated Rate |
$4,504.00 |
| Max. Negotiated Rate |
$40,332.14 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,035.35
|
| Rate for Payer: Cigna of CA PPO |
$14,790.00
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,332.14
|
| Rate for Payer: EPIC Health Plan Senior |
$29,875.66
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,875.66
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,875.66
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,033.38
|
| Rate for Payer: Multiplan WC |
$20,357.18
|
| Rate for Payer: Prime Health Services WC |
$20,149.45
|
| Rate for Payer: United Healthcare All Other Commercial |
$27,003.00
|
| Rate for Payer: United Healthcare All Other HMO |
$19,364.00
|
| Rate for Payer: United Healthcare HMO Rider |
$14,707.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$13,475.00
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC
|
Facility
|
IP
|
$40,049.57
|
|
|
Service Code
|
MSDRG 433
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$40,049.57 |
| Rate for Payer: Aetna of CA HMO/PPO |
$32,432.06
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,049.57
|
| Rate for Payer: EPIC Health Plan Senior |
$29,666.35
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,666.35
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,666.35
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$39,752.91
|
| Rate for Payer: Multiplan WC |
$19,985.42
|
| Rate for Payer: Prime Health Services WC |
$19,781.49
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC
|
Facility
|
IP
|
$59,392.08
|
|
|
Service Code
|
MSDRG 432
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$59,392.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$59,392.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,677.38
|
| Rate for Payer: EPIC Health Plan Senior |
$39,020.28
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$39,020.28
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$39,020.28
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$52,287.18
|
| Rate for Payer: Multiplan WC |
$36,598.83
|
| Rate for Payer: Prime Health Services WC |
$36,225.38
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC
|
Facility
|
IP
|
$34,748.84
|
|
|
Service Code
|
MSDRG 434
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,748.84 |
| Rate for Payer: Aetna of CA HMO/PPO |
$21,115.09
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,748.84
|
| Rate for Payer: EPIC Health Plan Senior |
$25,739.88
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,739.88
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,739.88
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,491.44
|
| Rate for Payer: Multiplan WC |
$13,011.64
|
| Rate for Payer: Prime Health Services WC |
$12,878.86
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: COAGULATION DISORDERS
|
Facility
|
IP
|
$46,929.17
|
|
|
Service Code
|
MSDRG 813
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$46,929.17 |
| Rate for Payer: Aetna of CA HMO/PPO |
$46,929.17
|
| Rate for Payer: EPIC Health Plan Commercial |
$46,839.88
|
| Rate for Payer: EPIC Health Plan Senior |
$34,696.21
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$34,696.21
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$34,696.21
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$46,492.92
|
| Rate for Payer: Multiplan WC |
$28,918.89
|
| Rate for Payer: Prime Health Services WC |
$28,623.80
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC
|
Facility
|
IP
|
$252,853.63
|
|
|
Service Code
|
MSDRG 429
|
| Min. Negotiated Rate |
$106,142.87 |
| Max. Negotiated Rate |
$252,853.63 |
| Rate for Payer: Aetna of CA HMO/PPO |
$252,853.63
|
| Rate for Payer: EPIC Health Plan Commercial |
$143,292.87
|
| Rate for Payer: EPIC Health Plan Senior |
$106,142.87
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$106,142.87
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$106,142.87
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$142,231.45
|
| Rate for Payer: Multiplan WC |
$155,814.53
|
| Rate for Payer: Prime Health Services WC |
$154,224.59
|
|
|
MS-DRG 42.00: COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC
|
Facility
|
IP
|
$165,843.68
|
|
|
Service Code
|
MSDRG 430
|
| Min. Negotiated Rate |
$75,954.29 |
| Max. Negotiated Rate |
$165,843.68 |
| Rate for Payer: Aetna of CA HMO/PPO |
$165,843.68
|
| Rate for Payer: EPIC Health Plan Commercial |
$102,538.29
|
| Rate for Payer: EPIC Health Plan Senior |
$75,954.29
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$75,954.29
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$75,954.29
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$101,778.75
|
| Rate for Payer: Multiplan WC |
$102,196.89
|
| Rate for Payer: Prime Health Services WC |
$101,154.06
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH CC
|
Facility
|
IP
|
$40,323.64
|
|
|
Service Code
|
MSDRG 381
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$40,323.64 |
| Rate for Payer: Aetna of CA HMO/PPO |
$33,017.16
|
| Rate for Payer: EPIC Health Plan Commercial |
$40,323.64
|
| Rate for Payer: EPIC Health Plan Senior |
$29,869.36
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,869.36
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,869.36
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$40,024.94
|
| Rate for Payer: Multiplan WC |
$20,345.98
|
| Rate for Payer: Prime Health Services WC |
$20,138.36
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITH MCC
|
Facility
|
IP
|
$58,337.08
|
|
|
Service Code
|
MSDRG 380
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$58,337.08 |
| Rate for Payer: Aetna of CA HMO/PPO |
$58,337.08
|
| Rate for Payer: EPIC Health Plan Commercial |
$52,183.24
|
| Rate for Payer: EPIC Health Plan Senior |
$38,654.25
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$38,654.25
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$38,654.25
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$51,796.69
|
| Rate for Payer: Multiplan WC |
$35,948.72
|
| Rate for Payer: Prime Health Services WC |
$35,581.90
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: COMPLICATED PEPTIC ULCER WITHOUT CC/MCC
|
Facility
|
IP
|
$35,498.56
|
|
|
Service Code
|
MSDRG 382
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$35,498.56 |
| Rate for Payer: Aetna of CA HMO/PPO |
$22,715.78
|
| Rate for Payer: EPIC Health Plan Commercial |
$35,498.56
|
| Rate for Payer: EPIC Health Plan Senior |
$26,295.23
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$26,295.23
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$26,295.23
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$35,235.61
|
| Rate for Payer: Multiplan WC |
$13,998.02
|
| Rate for Payer: Prime Health Services WC |
$13,855.18
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH CC
|
Facility
|
IP
|
$39,284.22
|
|
|
Service Code
|
MSDRG 920
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$39,284.22 |
| Rate for Payer: Aetna of CA HMO/PPO |
$30,798.02
|
| Rate for Payer: EPIC Health Plan Commercial |
$39,284.22
|
| Rate for Payer: EPIC Health Plan Senior |
$29,099.42
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$29,099.42
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$29,099.42
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$38,993.22
|
| Rate for Payer: Multiplan WC |
$18,978.49
|
| Rate for Payer: Prime Health Services WC |
$18,784.84
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITH MCC
|
Facility
|
IP
|
$55,284.26
|
|
|
Service Code
|
MSDRG 919
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$55,284.26 |
| Rate for Payer: Aetna of CA HMO/PPO |
$55,284.26
|
| Rate for Payer: EPIC Health Plan Commercial |
$50,753.33
|
| Rate for Payer: EPIC Health Plan Senior |
$37,595.06
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$37,595.06
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$37,595.06
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$50,377.38
|
| Rate for Payer: Multiplan WC |
$34,067.50
|
| Rate for Payer: Prime Health Services WC |
$33,719.87
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: COMPLICATIONS OF TREATMENT WITHOUT CC/MCC
|
Facility
|
IP
|
$34,623.86
|
|
|
Service Code
|
MSDRG 921
|
| Min. Negotiated Rate |
$6,823.00 |
| Max. Negotiated Rate |
$34,623.86 |
| Rate for Payer: Aetna of CA HMO/PPO |
$20,848.31
|
| Rate for Payer: EPIC Health Plan Commercial |
$34,623.86
|
| Rate for Payer: EPIC Health Plan Senior |
$25,647.30
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$25,647.30
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$25,647.30
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$34,367.38
|
| Rate for Payer: Multiplan WC |
$12,847.23
|
| Rate for Payer: Prime Health Services WC |
$12,716.14
|
| Rate for Payer: United Healthcare All Other Commercial |
$10,506.00
|
| Rate for Payer: United Healthcare All Other HMO |
$8,385.00
|
| Rate for Payer: United Healthcare HMO Rider |
$7,448.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$6,823.00
|
|
|
MS-DRG 42.00: CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES
|
Facility
|
IP
|
$330,259.47
|
|
|
Service Code
|
MSDRG 212
|
| Min. Negotiated Rate |
$7,611.00 |
| Max. Negotiated Rate |
$330,259.47 |
| Rate for Payer: Aetna of CA HMO/PPO |
$330,259.47
|
| Rate for Payer: EPIC Health Plan Commercial |
$179,549.01
|
| Rate for Payer: EPIC Health Plan Senior |
$132,999.27
|
| Rate for Payer: Inland Empire Health Plan (IEHP) Medicare Advantage |
$132,999.27
|
| Rate for Payer: Kaiser Permanente of CA Medicare Advantage |
$132,999.27
|
| Rate for Payer: Molina Healthcare of CA Medicare |
$178,219.02
|
| Rate for Payer: Multiplan WC |
$203,513.89
|
| Rate for Payer: Prime Health Services WC |
$201,437.21
|
| Rate for Payer: United Healthcare All Other Commercial |
$12,844.00
|
| Rate for Payer: United Healthcare All Other HMO |
$10,823.00
|
| Rate for Payer: United Healthcare HMO Rider |
$8,307.00
|
| Rate for Payer: United Healthcare Select/Navigate/Core |
$7,611.00
|
|
